Individual provider Active NPI

Stanley Mark Levenson

  • General Practice Dentistry
  • Worcester, MA
National Provider Identifier
1750394193
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16437 Issued in MA
Practice address
9 Linden St
Worcester, MA 01609-2510
Phone
(508) 753-3105
Fax
(508) 797-3740
NPI assigned
Aug 15, 2006
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16437 MA Primary

Addresses

Primary practice location

9 Linden St
Worcester, MA 01609-2510

Mailing address

9 Linden St
Worcester, MA 01609-2510
Phone (508) 753-3105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325001411 MA Practitioner - Dentist 3577577196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16437MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Stanley Levenson, DMD Current Accepting new patients
Stanley M Levenson DMD PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

9 Linden St
Worcester, MA 01609
Phone (508) 753-3105

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1750394193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 LINDEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092510",
            "telephone_number": "508-753-3105",
            "fax_number": "508-797-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LINDEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092510",
            "telephone_number": "508-753-3105",
            "fax_number": "508-797-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENSON",
        "first_name": "STANLEY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.